Clima de seguridad del paciente en cuatro servicios quirúrgicos de Santander / Patient Safety Climate in four Santander surgical units

Resumen Introducción: Conocer la percepción del clima de seguridad al interior de los servicios quirúrgicos es una tarea importante para establecer acciones que reduzcan el riesgo de eventos adversos durante la atención del paciente. Objetivo: Caracterizar el clima de seguridad en los servicios quirúrgicos de cuatro instituciones de salud de Santander. Materiales y métodos: Estudio observacional de corte transversal. Se aplicó el instrumento Hospital Survey on Patient Safety. Los resultados se reportaron como los promedios de repuestas positivas y negativas. Se analizaron las características asociadas a las dimensiones con mayores puntajes de percepción negativa. Resultados: Participaron 164 trabajadores. Las dimensiones con mayor percepción positiva fueron prácticas seguras (84 %), dotación de personal (83,2 %) y aprendizaje organizacional (78,4 %). Las dimensiones con percepción desfavorable fueron respuesta no punitiva al error (40,2 %), carga de trabajo (51,7 %), comunicación (54,3 %) y transiciones y transferencias entre servicios (58,1 %). Se encontró asociación entre una baja percepción en las transiciones y transferencias entre servicios con la contratación por prestación de servicios y con el cargo Médico Especialista y Anestesiólogo. Los bajos puntajes en comunicación se asociaron a la contratación gremial. No se encontraron factores asociados para las dimensiones respuesta no punitiva al error y carga de trabajo. Conclusiones: La percepción sobre clima seguridad en general es considerada positiva, aunque existen oportunidades de mejora. Los factores como tipo de contratación y cargo se asociaron a una percepción negativa de clima de seguridad. Los trabajadores se sienten juzgados al reportar eventos adversos.

Abstract Introduction: Knowing the perception of the safety climate within surgical services has become an important task to establish actions that reduce the risk of suffering adverse events during patient care. Objective: To characterize the safety climate in the surgical services of four health institutions in Santander. Materials and methods: Observational cross-sectional study. The Hospital Survey on Patient Safety instrument was applied. The results were reported as the means of positive and negative responses. The characteristics associated with the dimensions with the highest negative perception scores were analyzed. Results: 164 workers participated. The dimensions with the highest positive perception were safe practices (84 %), staffing (83.2 %) and organizational learning (78.4 %); Dimensions with unfavorable perception were non-punitive response to error (40.2 %), workload (51.7 %), communication (54.3 %) and transitions and transfers between services (58.1 %). Association between a low perception in transitions and transfers between services with contracting for the provision of services and with the position of Specialist (Physician and Anesthesiologist) was found. Low scores in communication were associated with union hiring. No associated factors were found for the non-punitive response to error and workload dimensions. Conclusions In general, the perception of safety climate is considered positive, although there are opportunities for improvement. Factors such as type of hiring and position were more associated with negative perception. Workers feel judged when reporting adverse events.

Reliability and validity of Health and Safety Climate Survey / 环境与职业医学

Background The health and safety climate of workplace has an important impact on the physical and mental health of workers. There is no available scale for the evaluation of workplace health and safety climate in China at present. Objective This study aims to sinicize and evaluate the reliability and validity of the Health and Safety Climate Survey. Methods The English version of Health and Safety Climate Survey was translated to Chinese and back-translated to English, and followed by expert evaluation to develop a Chinese version. Quota sampling method was used to select 2600 employees from 16 enterprises and public institutions in Pudong New Area of Shanghai and to evaluate the reliability and validity of the Chinese version of the scale. Structural validity, convergent validity, and discriminant validity were included in validity evaluation. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to test structural validity. In EFA, an acceptable factor loading of items on their respective dimensions was > 0.60. In CFA, an acceptable root mean square error of approximation (RMSEA), a standard absolute fitness index, was < 0.05. Comparative fit index (CFI) and parsimony-adjusted non-normed fit index (PNFI), measures of incremental improvement and fit, > 0.90 indicated a good fit. Convergent validity was evaluated by average variance extracted (AVE), and an AVE > 0.50 indicated good convergent validity. Discriminant validity was determined as good by the square root of AVE greater than the correlation coefficient between latent variables. Cronbach’s α coefficient was used to evaluate the internal consistency of the scale; the internal consistency considered was very good with an α > 0.90. Cronbach’s α coefficient may cause underestimation of reliability in the case of error correlation. Therefore, composite reliability (CR) calculated based on structural equation model >0.70 indicated that the CR was good. Results The response rate was 95.69%. The Chinese version of Health and Safety Climate Survey included 22 items belonging to six dimensions which was extracted by the EFA, and the cumulative variance contribution rate was 74.79%. The corrected RMSEA was 0.045, the PNFI was 0.970, and the CFI was 0.975 in the CFA, indicating good fit. The dimensional AVE values were all greater than 0.50, indicating good CV. The square root of AVE was greater than the correlation coefficient between latent variables, indicating good DV. The Cronbach’s α was 0.90 for the total scale and were above 0.70 for all dimensions. The CR was 0.93 for the total scale and were above 0.70 for all dimensions, indicating that the overall reliability of the scale was good. Conclusion The Chinese version of Health and Safety Climate Survey has good reliability and validity, and can be further improved in field application.

Patient safety climate in operating rooms at Colombian hospitals: differences by profession and type of contract / Clima de seguridad del paciente en unidades quirúrgicas de hospitales colombianos: diferencias por profesión y tipo de contratación

Abstract Introduction: The safety climate (SC) measurement in the hospitals, is essential for the development of a patient safety policy (PSP). Information about SC in the operating rooms is scarce. Objective: To measure the dimensions of SC in Colombian Operating Rooms according to characteristics of surgical staff. Methods: Cross-sectional study. The Hospital Survey on Patient Safety and an additional module for operating rooms were administered to healthcare workers in 6 high-complexity hospitals in the Metropolitan Area of Medellín (Colombia). The positive responses percentage for each dimension was measured. Differences by profession and type of contract were analyzed. Results: A total of442 participants were included. The workers in the operating rooms perceive a weak SC in terms of non-punitive response to error and workload (49.4% and 59.3% positive responses, respectively). Differences were found between physicians and nurses with lower scores in nursing for dimensions related to patient care. Anesthesiologists present low scores in events reporting. There are also differences by the type of work contract. Conclusion: Despite the PSP, the perception of a punitive culture to error, with a high workload. Recognizing differences between the groups within the surgical units helps to focus interventions strengthening the patient safety.

Resumen Introducción: La medición del clima de seguridad (CS) en las instituciones de salud es parte fundamental del desarrollo de una política de seguridad del paciente (PSP). Existe poca información acerca de la medición de clima de seguridad en las unidades quirúrgicas. Objetivo: Medir las dimensiones del CS en las unidades quirúrgicas de seis instituciones de salud colombianas según las características del personal. Métodos: Estudio de corte transversal. El cuestionario sobre seguridad del paciente en los hospitales (HSOPS) más la adición de un módulo para unidades quirúrgicas se aplicó al personal de seis hospitales de III nivel de Medellín (Colombia). Se midió el porcentaje de respuestas positivas para cada dimensión del CS. Se analizaron las diferencias por profesión y tipo de contratación. Resultados: Se incluyeron 442 participantes. El personal de las unidades quirúrgicas percibe un CS débil en respuesta no punitiva al error y carga de trabajo (49,4 % y 59,3 % de respuestas positivas respectivamente). Se encontraron diferencias entre personal médico y de enfermería con puntajes más bajos de percepción de CS en enfermería para aquellas dimensiones relacionadas con cuidado del paciente. Los anestesiólogos presentan puntajes bajos en el reporte de eventos. Existen además diferencias según el tipo de contrato de trabajo. Conclusiones: A pesar de la implementación de políticas de seguridad del paciente, persiste la percepción de una cultura punitiva frente al error, con una carga de trabajo elevado. El reconocimiento de las diferencias entre los grupos en las unidades quirúrgicas permitirá focalizar intervenciones que fortalezcan la seguridad del paciente.

The Influence of Safety Climate, Safety Leadership, Workload, and Accident Experiences on Risk Perception: A Study of Korean Manufacturing Workers

BACKGROUND: The purpose of this study was to identify the influence of workers' perceived workload, accident experiences, supervisors' safety leadership, and an organization's safety climate on the cognitive and emotional risk perception. METHODS: Six hundred and twenty employees in a variety of manufacturing organizations were asked to complete to a questionnaire. Among them, a total of 376 employees provided valid data for analysis. To test the hypothesis, correlation analysis and hierarchical regression analysis were used. Statistical analyses were conducted using IBM SPSS program, version 23. RESULTS: The results indicated that workload and accident experiences have a positive influence and safety leadership and safety climate have a negative influence on the cognitive and emotional risk perception. Workload, safety leadership, and the safety climate influence perceived risk more than accident experience, especially for the emotional risk perception. CONCLUSION: These results indicated that multilevel factors (organization, group, and individual) play a critical role in predicting individual risk perceptions. Based on these results, therefore, to reduce risk perception related with unsafe behaviors and accidents, organizations need to conduct a variety of safety programs that enhance their safety climate beyond simple safety-related education and training. Simultaneously, it needs to seek ways to promote supervisors' safety leadership behaviors (e.g., site visits, feedback, safety communication, etc.). In addition, it is necessary to adjust work speed and amount and allocate task considering employees' skill and ability to reduce the workload for reducing risk perception.

Introduction to Customized Occupational Safety and Health website and Its Effectiveness in Improving Psychosocial Safety Climate (PSC) among Police Officers

@#Introduction: The prevalence of stress among Malaysian police is high in which 38.8% polices have severe stress related to work resources and workplace environment. Psychosocial safety climate is one of the indicators that can be used to avoid psychosocial health problems. Objective: This study was conducted to determine the risk factors of psychosocial safety climate and to measure the effectiveness of a customised safety website in improving the safety climate. Methodology: This study involved 105 police officers who were randomly selected from nine different departments in PDRM Bukit Aman. A survey adapted from previous study was used to determine the psychosocial safety climate levels among respondents. Then, occupational safety website was introduced to the respondents and being used for two weeks. Lastly, post survey was done to see the difference of psychosocial safety climate before and after the use of the website. Results and Discussion: Findings showed that team psychological safety (r=0.381, p=<0.001) and physical safety climate (r=0.657, p=<0.001) were significantly associated with psychosocial safety climate level. The means before (36.095 ± 5.6202) and after (37.742 ± 4.7069) the introduction of occupational safety website was good. Still, there was a significant improvement of psychosocial safety climate level after the introduction of occupational safety website. Conclusion: This study showed that psychosocial safety climate level in an organization can be improved by introducing an informative website specific for polic

Safety Climate and Occupational Stress According to Occupational Accidents Experience and Employment Type in Shipbuilding Industry of Korea

BACKGROUND: Safety climate and occupational stress are related with occupational accident. The present study tried to identify the differences in safety climate and occupational stress according to occupational accidents experience and employment type (e.g., direct workers and subcontract workers). METHODS: In this study, we conducted a survey using safety climate scale and Korean Occupational Stress Scale and classified the participants into four groups: direct workers working for accident-free departments, direct workers working for accident departments, subcontract workers working for accident-free departments, and subcontract workers working for accident departments for 2 years within the same workplace in the shipbuilding industry. RESULTS: The direct workers and subcontract workers showed diverse results in subscales of safety climate and occupational stress. This result is supported by existing studies; however, further study is necessary for more supporting evidence and elaborative methodological approach. CONCLUSION: The necessity of management for safety climate and psychosocial factor such as occupational stress for both direct workers and subcontract workers as a whole is suggested by this study.

Cultura de seguridad y eventos adversos en una clínica de primer nivel / Culture of safety and adverse events in a first level clinic / Cultura de segurança e eventos adversos em uma clínica de primeiro nível

Objetivo: Identificar la percepción sobre clima y cultura de seguridad, y determinar la prevalencia de eventos adversos en el personal de enfermería de una clínica de primer nivel. Métodos: Estudio descriptivo, transversal y prospectivo, desarrollado en una clínica de medicina familiar del sur de la ciudad de México. Se aplicó el cuestionario Hospital survey on patient safety culture. Se utilizó estadística descriptiva. Los datos se capturaron y analizaron en el programa estadístico SPSS versión 22. Resultados: Aceptaron participar en el estudio 27 profesionales de enfermería. El promedio de edad fue de 44.7 años. Cerca del 15% refirió percibir un clima de seguridad del paciente entre excelente y muy bueno. El 66.7% del personal de enfermería describió no haber notificado ningún evento adverso. La dimensión retroalimentación y comunicación sobre errores con 75.3% aparece globalmente como fortaleza. En las debilidades percibidas, destacan 2 dimensiones: respuesta no punitiva a los errores con 61.7% y dotación de personal con 62%, ambas corresponden al área o rubro de cultura de seguridad en el nivel servicio. Conclusiones: Cerca de la tercera parte de los entrevistados no habían reportado ningún evento adverso en los últimos años, además de que solo un poco más de la mitad refirió percibir un clima de seguridad del paciente entre aceptable y superior.

Objective: To identify the perception on climate and culture of safety and prevalence of adverse events among nurses in a first level clinic. Methods: This is a descriptive, transversal and prospective study conducted in a family medicine clinic located at the south of Mexico City. The questionnaire hospital survey on patient safety culture was used. Descriptive statistics were obtained and analyzed with spss v22. Results: A total of 27 nurses agreed to participate in the study. The average age of the participants was 44.7 years old. Close to 15% said they perceive a patient safety climate between excellent and very good. The 66.7% describe having not noticed any adverse event. The dimension of feedback and communication about errors with 75.3% appears globally as a strength. In the perceived weaknesses, 2 dimensions stand out: non-punitive response to errors with 61.7% and staffing with 62% both correspond to the area or culture of service-level safety culture. Conclusions: Approximately one third of the interviewed had not reported any adverse event during the previous years, while a little more than half perceive a patient safety climate between acceptable and superior.

Objetivo: Identificar a percepção sobre clínica e cultura de segurança, e determinar a prevalência de eventos adversos em enfermeiras/os de uma clínica de primeiro nível. Métodos: Estudo descritivo, transversal e prospetivo, desenvolvido em uma clínica de medicina familiar do sul da Cidade do México. Aplicou-se o questionário hospital survey on patient safety culture: utilizou-se estatística descritiva, os dados capturaram-se e analisaram no programa estatístico spss versão 22. Resultados: Aceitaram participar no estudo vinte e sete enfermeiras/os. A média de idade foi de 44.7 anos. Cerca do 15 % refere perceber um clima de segurança do paciente entre excelente e muito bom. O 66.7% das enfermeiras/os descrevem não ter notificado nenhum evento adverso. A dimensão dos erros de feedback e comunicação com 75,3% aparece globalmente como uma fortaleza. Em debilidades percebidas, existem duas dimensões: nenhuma resposta punitiva a erros com 61,7% e de pessoal com 62%, tanto para a área ou categoria de cultura de segurança no nível de serviço. Conclusões: Cerca da terceira parte 2 entrevistados não tinham reportado algum evento adverso nos últimos anos, além disso que um pouco mais da metade refere perceber um clima de segurança do paciente entre aceitável e superior.

Cultura de segurança do paciente: estudo com métodos mistos

Instituições de saúde onde a cultura de segurança do paciente é positiva caracterizam-se por comunicação pautada em confiança mútua, por percepções compartilhadas sobre a importância de prestar cuidados seguros e pela confiança na eficácia de medidas preventivas. Nesta perspectiva, o objetivo geral do estudo consistiu em analisar a cultura de segurança do paciente junto à equipe multiprofissional de um centro avançado de neurologia e neurocirurgia da região sul do Brasil. À luz do pensamento restaurativo, desenvolveu-se o estudo com método misto sequencial explanatório. A pesquisa tramitou na Plataforma Brasil, obteve aprovação mediante CAAE 39941114.4.0000.5347 e os dados foram coletados entre outubro de 2015 e fevereiro de 2016, em duas fases...

Health care institutions with positive patient safety have their communication based on mutual trust, shared perceptions on the importance of providing safe care, and on reliable preventive measures. Under this perspective, this study aimed to analyze patient safety culture among a multi-professional team in an advanced neurology and neurosurgery center in southern Brazil. In light of restorative thinking, a sequential explanatory mixed methods design was developed. This research was submitted to Plataforma Brasil and received approval (CAAE 39941114.4.0000.5347) and the data were collected in two phases between October 2015 and February 2016...

Instituciones de salud en las cuales la cultura de seguridad del paciente es positiva se caracteriza por comunicación basada en confianza mutua, por percepciones compartidas sobre la importancia de servir con cuidados seguros y por la confianza en la eficacia de medidas preventivas. En esta perspectiva, el objetivo general del estudio se constituye en analizar la cultura del paciente junto al equipo multiprofesional de un centro avanzado de neurología y neuroquirurgia de la región sur de Brasil. Con base en el pensamiento de restauración, se desarrolló el estudio con método mixto secuencial explanatorio. La investigación tramitó en la Plataforma Brasil, obteniendo aprobación mediante CAAE 3991114.4.0000.5347 y los datos fueron recolectados entre octubre de 2015 y febrero de 2016, en dos etapas...

Diseño y validación de una herramienta para medir la percepción de las condiciones de trabajo: caso Sector manufacturero de la región Caribe colombiana / Design and Validation of an Instrument to Measure the Perception of Working Conditions: Case ManufacturingSector Colombian Caribbean Region

El Cuestionario de Condiciones de Trabajo fue diseñado y aplicado como una herramienta de evaluación de la percepción de la seguridad en el trabajo en una muestra de 518 empleados de diferentes empresas del sector manufacturero de la región Caribe colombiana. Se realizaron análisis de confiabilidad, análisis factorial exploratorio y análisis de componentes principales con rotación VARIMAX. Los resultados exhiben una aceptable confiabilidad interna de la escala (a = 0.793) y una adecuación satisfactoria de los datos a la matriz factorial (KMO = 0.785). La estructura factorial quedó representada por 17 ítems escalonados en cinco grupos: carga física, ambiente térmico, ruido, riesgos laborales y seguridad en el trabajo. Finalmente, el instrumento confirma una confiabilidad adecuada de gran utilidad para la comprensión e implementación de estrategias de acción en cuanto a la realización de modificaciones en las condiciones de trabajo en el sector para lograr satisfacción entre los empleados.

The Working Conditions Survey was designed and applied as a tool for assessing psychosocial components of job safety in a sample of 518 employees from different companies in the manufacturing sector of the Colombian Caribbean region. Reliability analysis, exploratory factor analysis and principal components analysis with VARIMAX rotation were performed. Results show acceptable internal reliability of the scale (a = 0.793) and satisfactory adequacy of factorial matrix data (KMO = 0.785). The factorial structure was represented by 17 items staggered into five groups: physical load, thermal environment, noise, occupational hazards and safety at work. In conclusion confirms the instrument adequate reliability and structural stability useful for the analysis and design of programs in order to implement changes in working conditions to achieve employee satisfaction.

Investigation of safety culture in a naval destroyer force of Chinese PLA / 第二军医大学学报

Objective To validate the dimensions and items of safety culture of PLA navy by surveying the sailors and officers of a naval destroyer force using questionnaire, so as to provide evidence for designing and validating a safety culture scale for Chinese naval destroyer forces. Methods An initial safety culture scale was designed using 38 items of 6 dimensions based on previous literature. And a refined scale, which included 28 items of 5 dimnesions, was set up through pre-investigation and pre-analysis. The refined scale was then used to survey all the 421 military members of a naval destroyer force of Chinese PLA. A total of 396 (94. 06%) validated questionnaires were recollected for analysis. Results It was found that 69 (17. 42%) responders had experienced safety accidents, and 30. 43% (21/69) of them were injured in the accidents. Exploratory factor analysiswas performed to validate the five dimensions in the scale: satisfaction with safety, management commitment, supportive environment, priority of safety and work pressure, with the total variance explained being 67. 62% and the Cronbach’s α calculated for each dimension being all over 0. 8, indicating a good internal consistency. The dimension scores showed that management commitment to safety was insufficient and the priority of safety was low. Conclusion The safety culture has great room for improvement in the naval destroyer force. Insufficient management commitment to safety impedes the education of safety, and the low priority of safety demands more emphasis on safety issues in the destroyer force. Although most dimensions of the scale have been confirmed, lack of communication dimension indicates pertinent dimensions should be designed with specific items for eastern nations.

Validity Assessment of the Persian Version of the Nordic Safety Climate Questionnaire (NOSACQ-50): A Case Study in a Steel Company

BACKGROUND: The Nordic Safety Climate Questionnaire-50 (NOSACQ-50) was developed by a team of Nordic occupational safety researchers based on safety climate and psychological theories. The aim of this study was to develop and validate the Persian version of NOSACQ-50 and assess the score of safety climate on a group of workers in a steel company in Iran. METHODS: The Persian version of NOSACQ-50 was distributed among 661 employees of a steel company in Qazvin Province (Iran). Exploratory factor analysis (EFA) and confirmatory factor analysis were used to determine the dimensions of the questionnaire. The reliability of the questionnaire was assessed using Cronbach α coefficient. Pearson correlation test was applied to investigate the correlation between different dimensions. RESULTS: The results of EFA showed that the Persian version of NOSACQ-50 consisted of six dimensions. The Cronbach α coefficient of the questionnaire was 0.94. The mean score of safety climate in all dimensions was 2.89 (standard deviation 0.60). CONCLUSION: The Persian version of NOSACQ-50 had a satisfactory validity for measuring safety climate in the studied Iranian population.

The Impact of Safety Climate and Fatigue on Safety Performance of Operating Room Nurses / 간호행정학회지

PURPOSE: This study was conducted to evaluate the level of safety climate, fatigue, and safety performance and to identify the impact of safety climate and fatigue on the safety performance of operating room nurses. METHODS: The study design was a descriptive survey. Participants were 174 operating room nurses from two general hospitals and two university hospitals in S and D cities. Three structurally designed questionnaires were used to evaluate their safety climate, fatigue, and safety performance. Collected data were analyzed using descriptive analysis, t-tests, ANOVAs, Pearson correlation coefficient, and stepwise multiple regression. RESULTS: Safety performance of operating room nurses had a mean of 3.26 on a 5-point scale. ‘Current department career’(β=.17, p=.006) and ‘safety climate (work-unit contribution) (β=.63, p<.001) accounted for 39% of the variance in operating room nurses’ safety performance. CONCLUSION: Findings indicate that work-unit contribution towards safety climate is an important factor in increasing operating room nurses' safety performance. Therefore, it is essential to find motivational properties consistent with the characteristics of the operating room environment.

Condições de trabalho e clima de segurança dos operários da construção de edificações / Working conditions and safety climate of construction workers / Las condiciones de trabajo y el clima de seguridad entre los trabajadores de la construcción de edificios

Este artigo explorou como operários percebem as condições de trabalho e o clima de segurança na organização em que trabalham e quais são as relações entre as percepções dos dois fenômenos. Foi aplicado um questionário sobre condições de trabalho e outro sobre clima de segurança. Participaram 195 operários de uma construtora e incorporadora da construção de edificações de Belo Horizonte. Foram realizadas análises estatísticas das respostas aos questionários. Os resultados indicaram que os participantes percebem o trabalho como repetitivo, com situações desgastantes e expostos a mudanças físicas naturais. Sentem-se exigidos em sua qualificação profissional e valorizam o trabalho em equipe e com flexibilidade para a definição de suas atividades.A análise de cluster identificou perfis de clima de segurança e ausência de clima consolidado de segurança. Aplicando a ANOVA, verificou-se que os fatores Movimentos repetitivos, Trabalho em equipe, Falta de apoio na execução das tarefas e Discriminação social e sexual influenciam significativamente os perfis de clima de segurança.Conclui-se que a percepção das condições de trabalho pode afetar a percepção do clima de segurança.

This article explored how workers perceive their working conditions and aspects of the safety climate in their organization, and what the relations are between the perceptions of the two phenomena.We applied one questionnaire about working conditions and another about safety climate. The participants were 195 workers from a contracting company in Belo Horizonte. Statistical analyses were conducted on participant responses.The results showed that they perceive the work as repetitive, leading to stressful situations and exposure to natural physical changes. They are challenged in their professional capacities, and value teamwork and flexibility in defining their activities. Cluster analysis identified safety climate profiles and the absence of a consolidated safety climate. Using ANOVA we found that the factors Repetitive movements, Teamwork, Lack of job performance support, and Social and gender discrimination significantly influence the safety climate profiles. We concluded that the perception of working conditions can affect the perception of safety climate.

El artículo abordó cómo perciben los operarios sus condiciones de trabajo y el clima de seguridad en la organización en que trabajan y cuáles son las relaciones entre las percepciones de esos dos fenómenos. Aplicamos un cuestionario sobre las condiciones de trabajo y otro sobre el clima de seguridad. Participaron 195 operarios de una empresa de construcción civil de Belo Horizonte. Realizamos análisis estadísticos de las respuestas a los cuestionarios. Los resultados indicaron que los participantes perciben que el trabajo es repetitivo, que provoca estrés y que los expone a cambios físicos naturales. Sienten que se les exige una cualificación profesional, valoran el trabajo en equipo con apertura a la definición de sus actividades. El análisis de clúster identificó perfiles del clima de seguridad y la ausencia de un clima consolidado de seguridad. Aplicando la ANOVA, descubrimos que los factores Movimientos repetitivos, Trabajo en equipo, Falta de apoyo a la ejecución de las tareas, Discriminación social y sexual influyen significativamente sobre los perfiles de clima de seguridad.Concluimos que la percepción de las condiciones de trabajo puede afectar a la percepción del clima de seguridad.

The study of influence about personal factors and organizational factors on nurses' career growth / 中国实用护理杂志

Objective To investigate the influence of work-family support,self-efficacy and psychological safety climate on nurses' career growth,and to establish a model of this influence.Methods Totally 382 registered nurses were recruited from four third level and grade A hospitals in Tianjin.They were investigated with Career Growth Scale (CGS),Work-Family Support Scale (WFSS),General Self-Efficacy Scale (GSES) and Psychological Safety Climate (PSC).Results The total effect of work-family support on nurses career growth was 0.562 with the 95％ confidence interval at 0.502-0.641;Indirect effect was 0.121 with the 95％ confidence interval at 0.065-0.207,both of the effects were statistically significant.The effect of work-family support-psychological security atmosphere-self-efficacy and career growth path accounted for 45.1％ of the total indirect effect with 95％ confidence interval at 0.197-0.201;the effect of work-family support-self-efficacy and career growth path accounted for 54.9％ of the total indirect effect with 95％ confidence interval at 0.066-0.068,the intermediary effect were established.Conclusions This study established a structural equation model connecting work-family support,self-efficacy,psychological security atmosphere,career growth and enucleate their internal connection.The administrators of nurses should provide nurses with support on both work and life,and help nurse with their career growth through increases of self-efficacy and psychological safety climate.

Development and Validation of a Safety Climate Scale for Manufacturing Industry

BACKGROUND: This paper describes the development of a scale for measuring safety climate. METHODS: This study was conducted in six manufacturing companies in Iran. The scale developed through conducting a literature review about the safety climate and constructing a question pool. The number of items was reduced to 71 after performing a screening process. RESULTS: The result of content validity analysis showed that 59 items had excellent item content validity index (> or = 0.78) and content validity ratio (> 0.38). The exploratory factor analysis resulted in eight safety climate dimensions. The reliability value for the final 45-item scale was 0.96. The result of confirmatory factor analysis showed that the safety climate model is satisfactory. CONCLUSION: This study produced a valid and reliable scale for measuring safety climate in manufacturing companies.

The relationship among psychological safety climate,proactive personality and nurse self-efficacy / 中国实用护理杂志

Objective To explore the relationship among psychological satety climate,proactive personality and self-efficacy.Methods Psychological safety climate scale,proactive personality scale,and self-efficacy scale were used to investigate a total of 228 registered nurses from two tertiary hospitals of Tianjin City from October to December,2013.Results The average points of nurses psychological safety climate was (3.05±0.53),average points of proactive personality was (2.70±0.48),average points of self-efficacy was (2.74±0.45),all were in the medium level.Both psychological safety climate and proactive personality could positively influence nursing self-efficacy directly(r=0349～0.472,P ＜ 0.01),and psychological safety climate could also indirectly influence nursing self-efficacy through the mediation of proactive personality (3 decreased from 0.472 to 0.352,P ＜ 0.01).Conclusions Hospi-tal should make concerted efforts to improve psychological safety climate and proactive personality so as to in-crease nurses' self-efficacy.

Avaliação da cultura de segurança em unidades cirúrgicas / Assessment of safety culture in surgical units

A segurança do paciente é destaque nos assuntos relativos à qualidade da assistência em saúde e desde 2004 estratégias para a promoção da cultura de segurança são veiculadas pela Organização Mundial de Saúde por meio dos Desafios Globais. Nesse sentido, o Questionário de Atitudes de Segurança (SAQ) como instrumento que permite avaliar a percepção da cultura de segurança em serviços de saúde, é composto por 41 itens distribuídos em seis domínios e quatro itens isolados; a pontuação obedece a escala de Likert com afirmativas que variam desde discordo totalmente a concordo totalmente e escores entre 0 e 100; acima de 75 os escores são considerados positivos para a cultura de segurança. Neste contexto, foram objetivos desta pesquisa: avaliar a cultura de segurança em Centro Cirúrgico Geral (CCG) e Centro Cirúrgico Gineco-Obstétrico (CCGO) de um hospital de ensino, compara-los por domínios entre unidades e população do estudo, e verificar a associação dos escores geral e por domínios e as variáveis de interesse . A pesquisa foi aprovada por Comitê de Ética em Pesquisa e a escolha das unidades de estudo foi intencional uma vez que desde 2010 o Programa Cirurgia Segura está em implantação na instituição participante. Trata-se de uma pesquisa quantitativa do tipo survey, realizada entre junho e agosto de 2013, por meio da aplicação do SAQ. A população alvo foi composta por profissionais dos centros cirúrgicos que atendessem aos critérios de inclusão e exclusão definidos, e foi constituída por 132 participantes, 79 do CCG e 54 do CCGO. Os resultados de cada questionário foram transcritos para o programa Excel® versão 2007 e processados pelo software Statistica v.8.0. Predominaram participantes do sexo feminino (75,8%) com tempo de atuação no hospital entre 11 a 20 anos (21,2%). Ao comparar a cultura de segurança por domínios entre sexo, foi observado que o melhor escore (77,7) esteve entre mulheres no domínio "Satisfação no trabalho", seguido por "Percepção do estresse" (77,3) entre homens. O menor escore foi identificado no domínio "Percepção da gerência" hospitalar (43,3) para sexo masculino. Quando observado o tempo de atuação dos profissionais de ambas unidades o domínio "Satisfação no trabalho" apresentou a melhor pontuação entre aqueles com mais de 20 anos de trabalho. Em contrapartida, os menores escores foram atribuídos aos domínios "Percepção da gerência" hospitalar e "Clima de trabalho em equipe" entre servidores de CCG e CCGO com um a dois anos de atividade. A comparação dos domínios por categoria profissional mostrou que no CCG auxiliares e técnicos de enfermagem sentem-se mais satisfeitos em seu ambiente de trabalho (83,8), corroborando com a percepção dos enfermeiros do CCGO (90,8). As menores percepções por categoria profissional (escore <75) foram atribuídas por médicos residentes do CCG em todos os domínios e para cinco domínios entre os atuantes no CCGO. Entre os itens isolados , a baixa comunicação com prejuízos para a pontualidade dos procedimentos (item 36) foi percebida com os menores escores entre todos os profissionais de ambos centro cirúrgicos. Quando comparados os centros cirúrgicos, os maiores escores foram atribuídos por enfermeiros e médicos do CCGO. Destacam-se os médicos residentes os quais apresentaram a maior frequência de escores negativos, exceto para o domínio "Percepção do estresse" para residentes do CCGO. De modo geral, os profissionais de saúde do CCG e CCGO estão satisfeitos com seu trabalho e considerando o Programa de cirurgia segura em implantação, os resultados direcionam para a necessidade de ações gerenciais com vistas à melhoria da cultura de segurança, sobretudo às questões relativas à comunicação.

Patient safety is the spotlight in subjects related to the quality of medical assistance in healthcare and since 2004 strategies to the promotion of a safety culture are conveyed by the World Health Organization through Global Challenges. In this sense, the Safety Attitudes Questionnaire (SAQ) as an instrument that allows evaluation of the safety culture perception in health services, is compounded by 41 items distributed in 6 domains and 4 isolated items; the score follows the Likert scale with affirmatives sentences that vary from completely disagree to completely agree and scores between 0 and 100; Scores above 75 are considered positive for safety culture. In this context, the objectives of this research were:To evaluate the safety culture on the General Surgical Center (GSV) and Gynecology and Obstetrics Surgical Center (GOSC) from a teaching hospital,to compare them by domains between units and population of the study,and verify the association of general and domain scores and variables of interest.The Research Ethics Committee approved the research and the study units choice was intentional, given that since 2010 the Safe Surgery Program is under implementation on the participant institution. This is a quantitative survey research, conducted between June and August of 2013, by applying the SAQ. The target population is composed by surgical center professionals who meet the defined inclusion and exclusion criteria, and was constituted by 132 participants, 79 from GSV and 54 from GOSC. The results of each questionnaire were transcribed using Excel® software version 2007 and processed using Statistica v.8.0. Software. Female participants (75,8%) who have been working at the hospital from 11 to 20 years (21,2%) were predominant. When comparing the safety culture by sex domains, it was observed that the best score (77.7) was among women within the domain "Job Satisfaction", followed by "Stress perception" (77.3) among men.The lowest score was identified on the domain "Hospital management perception" (43.3), for males. When observing the time the professionals from both units have been acting on the field the domain "Job Satisfaction" showed the best scores among those who have 20 or more years of work.On the other hand, the lowest scores were attributed to the "Hospital management perception" and "Team work climate"among workers from GSV and GOSC working from one to two years in the area. The comparison of domains by professional category showed that at GSV nursing assistants and technicians feel more satisfied in their working environment (83,8), corroborating with the perception of the nurses from GOSC (90,8). The lowest perception by professional category (scores <75) were attributed by residents from GSV in all domains and for five domains among the staff from GOSC. Among the isolated items, the poor communication with losses to the procedures punctuality (item 36) was perceived with the lowest scores among all professionals from both surgical centers. When comparing the surgical centers, the highest scores were given by nurses and doctors from GOSC.Residents stand out as they provided the highest frequency for negative scores, except to the domain "Stress perception" from GOSC residents. In general, health professionals from GSV and GOSC are satisfied with their jobs and considering the Safe Surgery program that is being implemented, the results directed to the necessity of managing actions aiming to improve the safety culture, above all the questions related to communication.

Instrumentos de medida de clima de segurança no trabalho: uma revisão de literatura / Measure instruments of Safety Climate at work: a literature review

O objetivo deste trabalho é realizar uma avaliação crítica do construto clima de segurança e das medidas de clima de segurança no trabalho. O fenômeno clima de segurança no trabalho é definido como a percepção compartilhada que os membros da organização têm em relação ao seu compromisso com a gestão de segurança da organização e ao comportamento seguro no trabalho. Foram objetos de pesquisa 80 artigos e outras produções bibliográficas que se referem à construção e ao uso de instrumentos de medida de clima de segurança em diferentes contextos: industrial, transporte, construção civil e hospitalar, correspondente ao período de 1980 a 2008. Conclui-se que os instrumentos de medida de Clima de Segurança no Trabalho, assim como os aspectos teóricos que dão sustentabilidade a este construto, necessitam de aperfeiçoamento em sua matriz conceitual e metodológica, especialmente em relação à qualidade e ao controle de resultados do processo de mensuração.

This article intends to make a critical evaluation of the construct of safety climate and safety climate measures in the work environment.The safety climate in the work environment phenomenon is defined as the shared perception that the organization members in relation to their commitment to the organization's safety management and the safety behavior in the work environment.Eighty articles were objects of research,along with other bibliographic productions that refer to the construction and the use of safety climate measure instruments in different contexts:industrial,transport civil construction and hospitals,that correspond to for the period from 1980 to 2008.It was concluded that, although the measure instruments of the Safety Climate in the Work Environment,as well as the theoretical aspects that give sustainability to the construct, their conceptual and methodological origin need improvement, especially in relation to the quality and the control of the measuring process' results.

A model of safety performance in perioperative registered nurses.

Background: Health care in the 21st century places a greater emphasis on the quality of care. Safety climate data can serve as a benchmark for hospitals to gauge their safety performance in advancing patient safety. Objective: To propose and test a model of safety performance in perioperative registered nurses. Methods: The Workplace Health and Safety questionnaire and the Personal Strain questionnaire were administered to 240 perioperative registered nurses who work at seven university hospitals in Thailand. A path analysis using the Analysis of Moment Structures program version 7.0 was employed to test the hypothesized model relating safety climate, safety knowledge, safety motivation, personal strain and safety performance which is differentiated between the two types of safety performance; safety compliance and safety participation. Results: The results in this study confirmed the research model, in that the safety climate had a direct positive effect on safety knowledge and safety motivation, and had a direct negative effect on personal strain. Safety knowledge, safety motivation, and personal strain mediated the link between safety climate and safety compliance. Furthermore, safety motivation and personal strain also mediated the link between safety climate and safety participation. Conclusion: Health care managers can use the resulting data to design effective safety management systems and identify areas for improvement. Designing effective nursing management tools to enhance safety climate, safety knowledge, and safety motivation and to reduce personal strain should be further developed.

Modelo explicativo da adesão às precauções-padrão: construção e aplicação / Construction and application of a model for explaining compliance with standard precautions

A exposição ocupacional a material biológico é uma das questões mais proeminentes na área da Saúde e Segurança Ocupacional, pois coloca o profissional de saúde em risco de adquirir infecções transmitidas por via sanguínea. Há mais de uma década, esforços têm sido dirigidos para incentivar as medidas preventivas, denominadas, inicialmente, precauções universais (PU) e, posteriormente, precauções-padrão (PP). Entretanto, universalmente estudos têm demonstrado níveis insatisfatórios de adesão às recomendações das PP. A revisão da literatura aponta para a análise dos fatores que interferem na tomada de decisão dos profissionais de saúde baseada em três dimensões: indivíduo, trabalho e organização. Fundamentados nessa premissa, desenvolvemos um modelo teórico explicativo da adesão às precauções-padrão para identificar a influência dos fatores individuais, relativos ao trabalho e organizacionais. A aplicação desse modelo em 270 profissionais médicos e de enfermagem de um hospital universitário revelou importantes diferenças entre os dois grupos profissionais: (1) os profissionais de enfermagem relataram níveis significativamente maiores de adesão às recomendações para "seguir as PP com todos os pacientes", "lavar as mãos após retirar luvas", "usar avental protetor", e ao conjunto de itens relacionados à manipulação e descarte de objetos perfurocortantes; (2) os profissionais de enfermagem relataram perceber mais intensamente os aspectos organizacionais de apoio a adoção das precauções-padrão; (3) os fatores individuais, relativos ao trabalho e organizacionais explicaram 38,5% do índice global de adesão; (4) o índice global de adesão foi explicado por pertencer ao grupo profissional de médicos; ter recebido treinamento em PP; perceber menos intensamente os obstáculos para seguir as PP; perceber mais intensamente a carga de trabalho, o feedback das práticas de segurança, e as ações gerenciais de apoio à segurança. ) Os resultados obtidos possibilitaram a discussão de um programa para o gerenciamento dos riscos ocupacionais relacionados à exposição a material biológico cujas diretrizes foram assim definidas: (1) educação para consciência; (2) controle de engenharia; (3) controle das práticas de trabalho.

The bloodborne pathogens exposure is a salient issue for Occupational Health and Safety so that it places health care workers on bloodborne infections risks. For almost two decades, efforts have been drived to encourage safety practices named, first, universal precautions, and after, standard precautions. However, studies have showed poor levels of compliance with these recommendations. The literature points out the factors that interfere in the health care workers decision-making which are centred on tree dimensions: individual, job/task, and organization. Based on this premise, we developed a theorethical model for explaining compliance with standard precautions and to identify the influence of individual, job-related, and organization factors. The application of this model on 270 heath care workers at a university hospital shows that: (1) nursing staff reported higher levels of compliance with some recommendations than physicians did; (2) nursing staff perceived strongly the organization support for adherence with PP than physincians did; (3) the individual, job-related and organization factors predicted 38,5% of general compliance level differences among individuals. The empirical investigation also shows that general compliance levels are explained by the following variables: being physician; having receveid PP training at university hospital; perceiveing less likely job hidrances for using PP, and perceiveing strongly workload, feedback of safety practices, management actions and commitment with safety. The conclusions of this research aid to organize a program to management bloodborne occupacional exposure whose directives was defined as: raising awareness through education; engineering control; and work practices control.